New indication for preoperative marking of small peripheral pulmonary nodules in thoracoscopic surgery

Tamura, Masaya; Oda, Makoto; Fujimori, Hideki; Shimizu, Yosuke; Matsumoto, Isao; Watanabe, Go

doi:10.1510/icvts.2010.241018

Cited by 30 publications

(19 citation statements)

References 9 publications

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“…[18], who found a similar relation of size and depth of location to probability of successful videothoracoscopic detection. However, if we analyze the date more closely, we can find that not all of these presented statistically significant results are good predictors for assessment of probability of successful detection of the tumor.…”

Section: Discussionmentioning

confidence: 83%

Videothoracoscopic identification of chondromatous hamartoma of the lung.

Bohanes

Szkorupa²,

Klein³

et al. 2013

Videosurgery and Other Miniinvasive Techniques

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IntroductionThe main disadvantage of a videothoracoscopic procedure is the lack of touch sensation. The probability of easily finding the lesion is usually estimated according to computed tomography (CT).AimTo find useful parameters of location of chondromatous hamartoma of the lung parenchyma in relation to its size to assess the probability of successful search via a videothoracoscopic approach only.Material and methodsA group of 55 patients operated on for chondromatous hamartoma of the lung at the First Department of Surgery in Olomouc from January 2006 to June 2011 was analyzed. Initially, the tumor's longest diameter and its nearest distance to the pleural surface were measured on CT scans. Subsequently, the surgery began using the videothoracoscopic approach. A short thoracotomy with direct palpation followed when videothoracoscopy failed.ResultsNo significant differences in age, sex and side of localization between the group with and without successful videothoracoscopic detection were found. A significant difference was found in the median size (p = 0.026) and the depth of the tumor (p < 0.0001) and in the calculated index “tumor size/depth” (p < 0.0001). Deeper analysis revealed that the parameters “depth” and “index size/depth” are considered to be good predictors but the parameter “size” is not a suitable predictor.ConclusionsThe main predictors of successful videothoracoscopic detection of lung chondromatous hamartoma are considered to be the depth of the tumor in the lung parenchyma with a cut-off value ≤ 7.5 mm and the index “size/depth” with a cut-off value ≥ 1.54; the tumor size is not considered to be a good predictor.

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Section: Discussionmentioning

confidence: 83%

Videothoracoscopic identification of chondromatous hamartoma of the lung.

Bohanes

Szkorupa²,

Klein³

et al. 2013

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

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“…The present report demonstrates that imaginary auxiliary lines do indeed assist intraoperative location of unexpected tumors. Because the additional tumors were <5 mm in diameter and both were >5 mm from the pleural surface, the probability of successfully locating them without markings was extremely low [7]. The auxiliary lines combined with VAL-MAP and anatomical landmarks enabled complete resection of all nodules with sufficient surgical margins, as is important in oncological surgery [8].…”

Section: Discussionmentioning

confidence: 99%

Management of lung nodules newly found by virtual-assisted lung mapping: a case report

et al. 2017

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BackgroundVirtual-assisted lung mapping is a novel bronchoscopic lung marking technique that uses virtual images to perform multiple concurrent dye marking of barely palpable pulmonary tumors. Subsequent chest computed tomography is required to confirm the locations marked. We here report a patient in whom computed tomography after virtual-assisted lung mapping unexpectedly revealed additional tiny pulmonary nodules.Case presentationA 64-year-old woman with a history of renal cell carcinoma presented with two pulmonary nodules suspicious of metastases from renal cell carcinoma. Because we anticipated that the nodules would be difficult to palpate intraoperatively, we performed virtual-assisted lung mapping prior to attempting to resect them. Computed tomography after mapping unexpectedly detected two additional nodules. Although the existing markings did not relate to the newly found nodules, we used imaginary auxiliary lines and anatomical landmarks to extend the lung map to incorporate the unexpected nodules. The additional nodules were successfully resected by thoracoscopic wedge resection. Pathologic examination identified all nodules as metastases from renal cell carcinoma, and the surgical margins were negative.ConclusionsImaginary auxiliary lines and anatomical landmarks extended the existing lung map of virtual-assisted lung mapping, enabling resection of unexpected pulmonary nodules found in post-mapping computed tomography images.

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“…For some pulmonary nodules in specific positions, trapezoid or obtuse triangle resection may be performed instead of the traditional wedge resection, due to selection of the position of the operating incision during thoracoscopic pulmonary wedge resection Tamura et al, 2010). In addition, it is difficult to perform deep wedge resections at sites on the truncated edge of the lung.…”

Section: Discussionmentioning

confidence: 99%

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Zhai

Guan

et al. 2015

Genet. Mol. Res.

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ABSTRACT.This study aimed to analyze the clinical application value of computed tomography (CT)-guided hook-wire positioning before thoracoscopic surgery. Eighty-four patients who had received a thoracoscopic wedge resection of pulmonary nodules between January and December 2013 were selected. Group A consisted of 38 cases where the hook-wire positioning technique was not used, and the positioning approaches were intraoperative observation and palpation. Group B consisted of 46 cases where the hook-wire positioning technique was used. The diameter of each nodule was less than 2 cm, and all patients underwent the operation within 2 h of invasive positioning. The evaluation indexes included positioning success rate, positioningrelated complications, and rate of conversion to thoracotomy. In Group A, nine patients (23.68%) underwent conversion to thoracotomy; in Group B, three patients (6.52%) did. This difference was statistically significant (P < 0.05). The average operation duration was 118 ± 21 min in Group A and 53 ± 18 min in Group B. The difference between both groups was statistically significant (P < 0.05). The average length 3799 Positioning of pulmonary nodules ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (2): 3798-3806 (2015) of hospital stay of patients who underwent conversion to thoracotomy was 8.7 ± 2.2 days, and of patients who underwent thoracoscopic pulmonary wedge resection was 4.5 ± 1.6 days. This difference was statistically significant (P < 0.05). Therefore, CT-guided hook-wire positioning of pulmonary nodules before thoracoscopic surgery has clinical application value. It helps to accurately locate the pulmonary nodules, effectively lowers the rate of conversion to thoracotomy, and reduces the operation duration.

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New indication for preoperative marking of small peripheral pulmonary nodules in thoracoscopic surgery

Cited by 30 publications

References 9 publications

Videothoracoscopic identification of chondromatous hamartoma of the lung.

Videothoracoscopic identification of chondromatous hamartoma of the lung.

Management of lung nodules newly found by virtual-assisted lung mapping: a case report

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

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